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1000 Titel
  • CO2 delivery techniques in mini-sternotomy surgery and neurological events: a multicentric study
1000 Autor/in
  1. Weltert, Luca P. |
  2. Audisio, Katia |
  3. Torre, Michele La |
  4. Dell’Aquila, Michele |
  5. Cancelli, Gianmarco |
  6. Lodo, Vittoria |
  7. Caldonazo, Tulio |
  8. Rossi, Camilla S. |
  9. Soletti, Giovanni J. |
  10. Garufi, Luigi |
  11. Centofanti, Paolo |
  12. De Paulis, Ruggero |
  13. Rinaldi, Mauro |
1000 Verlag BioMed Central
1000 Erscheinungsjahr 2024
1000 Publikationstyp
  1. Artikel |
1000 Online veröffentlicht
  • 2024-10-22
1000 Erschienen in
1000 Quellenangabe
  • 24(1):582
1000 Copyrightjahr
  • 2024
1000 Lizenz
1000 Verlagsversion
  • https://doi.org/10.1186/s12872-024-04237-8 |
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495089/ |
1000 Publikationsstatus
1000 Begutachtungsstatus
1000 Sprache der Publikation
1000 Abstract/Summary
  • <jats:title>Abstract</jats:title><jats:sec> <jats:title>Background</jats:title> <jats:p>The impact of air bubbles into the cerebral circulation after open heart surgery has been a topic of discussion since the introduction of the heart-lung machine. The aim of the study was to evaluate whether the use of a dedicated commercial sponge diffuser is better than a custom-made narrow section cannula or the absence of CO2 in preventing neurological events after aortic valve replacement via J mini-sternotomy.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>Three cohorts of J-shaped mini-sternotomy performed at three different centers were prospectively compared: CO2 supplied via sponge diffuser, CO2 supplied via cannula, and no CO2 supply. Propensity matching was used to obtain comparable groups. The primary endpoints were postoperative stroke, transitory ischemic attack, convulsions, and dizziness. Secondary endpoints were 30-day mortality, duration of mechanical ventilation, and intensive care unit length of stay.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>275 patients were enrolled in the study. After propensity matching, the sponge diffuser cohort had a significantly lower duration of mechanical ventilation (<jats:italic>P</jats:italic> &lt; 0.001) and 30-day mortality (<jats:italic>P</jats:italic> = 0.05) when compared to the cannula cohort and the no-CO2 cohort, a lower incidence of all neurological events (<jats:italic>P</jats:italic> = 0.03) and dizziness (<jats:italic>P</jats:italic> = 0.05) when compare to the no-CO2 cohort, and a lower intensive care unit length of stay when compared to the cannula cohort (<jats:italic>P</jats:italic> = 0.001).</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions</jats:title> <jats:p>The sponge diffuser used to deliver the CO2 into the surgical field during aortic valve replacement via J mini-sternotomy has been demonstrated to guarantee better neurological outcomes compared to a custom-made narrow section cannula or the absence of CO2.</jats:p> </jats:sec>
1000 Sacherschließung
lokal Aortic Valve/physiopathology [MeSH]
lokal Ischemic Attack, Transient/prevention
lokal Aged, 80 and over [MeSH]
lokal Aged [MeSH]
lokal Ischemic Attack, Transient/etiology [MeSH]
lokal Aortic Valve/surgery [MeSH]
lokal Risk Factors [MeSH]
lokal Heart Valve Prosthesis Implantation/mortality [MeSH]
lokal Carbon Dioxide [MeSH]
lokal Air embolism
lokal Male [MeSH]
lokal Cerebrovascular Circulation [MeSH]
lokal Postoperative neurological events
lokal Length of Stay [MeSH]
lokal Seizures/etiology [MeSH]
lokal Italy [MeSH]
lokal Female [MeSH]
lokal Sternotomy/adverse effects [MeSH]
lokal Humans [MeSH]
lokal Prospective Studies [MeSH]
lokal Treatment Outcome [MeSH]
lokal Middle Aged [MeSH]
lokal Stroke/prevention
lokal Time Factors [MeSH]
lokal Seizures/prevention
lokal Heart Valve Prosthesis Implantation/adverse effects [MeSH]
lokal Embolism, Air/etiology [MeSH]
lokal Research
lokal Cannula [MeSH]
lokal Carbon dioxide
lokal Heart Valve Prosthesis Implantation/instrumentation [MeSH]
lokal Embolism, Air/prevention
lokal Equipment Design [MeSH]
lokal Respiration, Artificial [MeSH]
lokal Stroke/etiology [MeSH]
lokal Mini-sternotomy
1000 Fächerklassifikation (DDC)
1000 Liste der Beteiligten
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    1000 Förderer Deutsche Herzstiftung |
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